On June 14, 2013, HHS released a proposed rule containing many provisions aimed at oversight of federally-facilitated exchanges (FFEs), state health insurance exchanges (State Exchanges), qualified health plan (QHP) issuers, and states with respect to risk adjustment and reinsurance programs and standards for agents and brokers. HHS also revises its prior interpretation of the Affordable Care Act to allow a state to operate only a Small Business Health Options Program (SHOP) while HHS operates an individual market FFE in that state. Additionally, the agency proposes standards regarding oversight of advance payments of the premium tax credit and cost-sharing reductions. Among many other provisions, the proposed rule also establishes standards for enrollee satisfaction survey vendors.

A display copy of the proposed rule is available here. The proposed rule is expected to be published in the Federal Register on June 19, 2013.

Enrollment in QHPs by qualified individuals and qualified employers for coverage starting January 1, 2014, is scheduled to begin in just a few months on October 1, 2013. According to CMS’s press release, CMS will re-launch its website, HealthCare.gov, this summer “where consumers will have access to real-time information and help to sign up for coverage during open enrollment in October.”

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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